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Importance of etiologic factors and electrocardiographic findings for diagnosis of emergency hyperkalemic patients

Gonca Koksaldi Sahin, Yuksel Gokel, Yeliz Simsek.




Abstract
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Background: Hyperkalemia is the life-threatening problem. Early diagnosis and treatment of patients with the possibility of hyperkalemia should be performed in emergency department. Comorbid diseases used medications and electrocardiography (ECG) findings can be important clues for the possibility of hyperkalemic states.

Objectives: In our study, we aimed to identify causes of hyperkalemia in patients who admitted to emergency department and to evaluate the importance of the relationship between hyperkalemia and ECG.

Materials and Methods: Our study desing was prospective. The patients who admitted to emergency department which has annual turnover of 70,000 patients between June 01, 2012, and June 01, 2014, were investigated. Total 100 patients aged 18 years and above who had hyperkalemia were included in the study. Patients were divided into three groups according to the level of potassium (1-mild: 5-5.9 mEq/L, 2-moderate: 6-7 mEq/L, 3-severe: >7 meq/L) and ECG finding of these hyperkalemic patients were evaluated. Patients were categorized according to etiology of hyperkalemia in four groups. They are chronic renal failure (CRF), acute renal failure (ARF), (angiotensin converting-enzyme inhibitor /angiotensin-receptor blocker (ACEI/ARB) use and spironolactone use.

Results: In our study, we included 100 patients with hyperkalemia. Potassium value of patients was maximum 8.1 mEq/L and mean value was 6.12 +/− 0.66 mEq/L. There was no significant correlation between the ECG and potassium level (P = 0.107). In our study, we found that the most contributing cause was CRF, the second was ARF and the third was ACEI/ARB +/− spironolactone.

Conclusions: According to our study, it should be kept in mind that even if the ECG findings are normal, hyperkalemia may occur in patients with ARF, CRF, spironolactone, and ACEI/ARB drug users.

Key words: Hyperkalemia; Electrocardiography; Emergency Department






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